Abdel Shaheed, C, Maher, CG, Mak, W, Williams, KA & McLachlan, AJ 2015, 'Knowledge and satisfaction of pharmacists attending an educational workshop on evidence-based management of low back pain', Australian Journal of Primary Health, vol. 21, no. 2, pp. 126-126.
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Pharmacists are well positioned to provide quality care to people with low back pain (LBP). Education and training can equip pharmacists with the knowledge to optimally manage LBP in primary care. The aim of this study was to investigate the knowledge and satisfaction of pharmacists who attended a 2-h educational workshop on the evidence-based management of LBP. Case-based learning, underpinned by key adult learning principles, was one teaching method used to deliver important educational messages. Knowledge was assessed using a questionnaire consisting of multiple-choice, true/false questions and a written vignette based on a real-life clinical case scenario. Written feedback from pharmacists was used to gauge the success and limitations of the intervention. One hundred and ninety-three pharmacists completed the in-house assessment. Pharmacists demonstrated an accurate understanding of evidence-based pharmacological management of LBP, with all identifying paracetamol as the first-line drug choice for non-specific LBP. Ninety-nine per cent of pharmacists identified the symptoms presented in the vignette as a syndrome representing a significant clinical red flag requiring urgent referral. This educational intervention has delivered key messages on LBP management to pharmacists. There is a continued need for educational interventions addressing common conditions.
Abdel Shaheed, C, Maher, CG, Mak, W, Williams, KA & McLachlan, AJ 2015, 'The effects of educational interventions on pharmacists’ knowledge, attitudes and beliefs towards low back pain', International Journal of Clinical Pharmacy, vol. 37, no. 4, pp. 616-625.
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Background Practitioner beliefs and attitudes towards low back pain (LBP) influence treatment decisions. Little is known about pharmacists’ knowledge, attitudes and beliefs towards LBP. Objectives To investigate the effect of educational interventions on pharmacists’ knowledge, attitudes and beliefs towards LBP. Setting Sydney Metropolitan Area. Methods Knowledge, attitudes and beliefs was measured using the “Pharmacists’ Back Beliefs Questionnaire”, with items from two previously reported questionnaires on back beliefs. Responses from pharmacists attending a 2-h educational workshop on LBP (n = 204) and pharmacists recruiting participants for a LBP clinical trial (n = 66) were compared to responses from a control group of pharmacists (n = 65) to allow an evaluation of the two interventions. Responses from workshop participants were also evaluated before and after the session. Participants indicated their agreement with statements about LBP on a 5-point Likert scale. Preferred responses were based on guidelines for the evidence-based management of LBP. The primary analysis evaluated total score on the nine-inevitability items of the Back Beliefs Questionnaire (“inevitability score”). Main outcome measure Inevitability score. Results There was no significant difference in inevitability score between LBP clinical trial pharmacists and the control group [mean difference (MD) 0.47 (95 % CI −1.35 to 2.29; p = 0.61)]. The educational workshop led to a significant and favourable change in inevitability score (MD 7.23 p < 0.001) and notable changes in responses to misconceptions regarding bed rest and the need for imaging (p < 0.001) among participating pharmacists. Conclusions Pharmacists attending the educational workshop provided the most compelling evidence that education specifically aimed at delivering evidence-based information can be successful in changing practitioner knowledge, beliefs and attitudes towards LBP.
Alhawassi, TM, Krass, I & Pont, LG 2015, 'Hypertension in Older Persons: A Systematic Review of National and International Treatment Guidelines', The Journal of Clinical Hypertension, vol. 17, no. 6, pp. 486-492.
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Despite good evidence regarding the benefits of managing hypertension in elderly populations, the extent to which this evidence has been incorporated into national and international clinical hypertension treatment guidelines is unknown. A systematic review was conducted to identify recommendations in current national and international hypertension treatment guidelines with a focus on specific targets and treatment recommendations for older persons with uncomplicated hypertension. Guidelines for the management of hypertension published or updated over a 5‐year period (2009–2014) were identified by searching Medline, Google, and Google Scholar. Thirteen guidelines that met the predefined inclusion criteria were included in the review. Among these guidelines was considerable variation regarding who is considered an older person. However, there was general consensus regarding blood pressure targets. While current hypertension guidelines do include recommendations regarding management of uncomplicated hypertension in older populations, the depth and breadth of these recommendations vary considerably between guidelines and may limit the usefulness of such treatment guidelines to clinicians.
Alhawassi, TM, Krass, I & Pont, LG 2015, 'Impact of Hospitalization on Antihypertensive Pharmacotherapy among Older Persons', Drugs - Real World Outcomes, vol. 2, no. 3, pp. 239-247.
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© 2015, The Author(s). Background: Little is known about the impact of hospitalization on antihypertensive pharmacotherapy and blood pressure control in older persons. Objectives: The aim of this study was to explore the impact of hospitalization on the management of hypertension and antihypertensive pharmacotherapy in a cohort of older patients with a documented diagnosis of hypertension. Methods: A retrospective, cross-sectional medical record audit was conducted in a large Australian metropolitan teaching hospital. Patients aged 65 years or older, admitted between January 1st 2010 and December 31st 2010, and with a documented diagnosis of hypertension in their medical record were included in the study. Antihypertensive pharmacotherapy and blood pressure control was compared between admission and discharge. Factors associated with changes to antihypertensive pharmacotherapy were identified. Results: Changes to antihypertensive pharmacotherapy occurred in 39.5 % (n = 135) of patients (n = 342). On discharge, the proportion of patients receiving antihypertensive pharmacotherapy (89.0 vs 85.3 %, p < 0.0001) and the mean number of antihypertensive agents per patient (1.7 ± 1.1 vs 1.5 ± 1.1, p < 0.0001) declined compared with admission. Adverse drug reactions [odds ratio (OR) = 5, 95 % confidence interval (CI): 2.80–9.34] were the main reason documented for antihypertensive pharmacotherapy changes. Patients admitted under the care of medical (OR = 0.3, 95 % CI: 0.17–0.70) or surgical (OR = 0.3, 95 % CI: 0.12–0.53) specialties were less likely to experience changes to their antihypertensive pharmacotherapy than those treated by gerontology or cardiology teams. Conclusions: Hospitalization has a significant impact on antihypertensive pharmacotherapy. Two out of every five older persons on antihypertensive medications will experience changes to their regimens during admission to hospital with most changes in antihypertensive pharmacotherapy due to adverse drug reaction...
Alhawassi, TM, Krass, I & Pont, LG 2015, 'Impact of Hospitalization on Antihypertensive Pharmacotherapy among Older Persons.', Drugs - real world outcomes, vol. 2, no. 3, pp. 239-247.
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Little is known about the impact of hospitalization on antihypertensive pharmacotherapy and blood pressure control in older persons.The aim of this study was to explore the impact of hospitalization on the management of hypertension and antihypertensive pharmacotherapy in a cohort of older patients with a documented diagnosis of hypertension.A retrospective, cross-sectional medical record audit was conducted in a large Australian metropolitan teaching hospital. Patients aged 65 years or older, admitted between January 1st 2010 and December 31st 2010, and with a documented diagnosis of hypertension in their medical record were included in the study. Antihypertensive pharmacotherapy and blood pressure control was compared between admission and discharge. Factors associated with changes to antihypertensive pharmacotherapy were identified.Changes to antihypertensive pharmacotherapy occurred in 39.5 % (n = 135) of patients (n = 342). On discharge, the proportion of patients receiving antihypertensive pharmacotherapy (89.0 vs 85.3 %, p < 0.0001) and the mean number of antihypertensive agents per patient (1.7 ± 1.1 vs 1.5 ± 1.1, p < 0.0001) declined compared with admission. Adverse drug reactions [odds ratio (OR) = 5, 95 % confidence interval (CI): 2.80-9.34] were the main reason documented for antihypertensive pharmacotherapy changes. Patients admitted under the care of medical (OR = 0.3, 95 % CI: 0.17-0.70) or surgical (OR = 0.3, 95 % CI: 0.12-0.53) specialties were less likely to experience changes to their antihypertensive pharmacotherapy than those treated by gerontology or cardiology teams.Hospitalization has a significant impact on antihypertensive pharmacotherapy. Two out of every five older persons on antihypertensive medications will experience changes to their regimens during admission to hospital with most changes in antihypertensive pharmacotherapy due to adverse drug reactions.
Alhawassi, TM, Krass, I & Pont, LG 2015, 'Prevalence, prescribing and barriers to effective management of hypertension in older populations: a narrative review', Journal of Pharmaceutical Policy and Practice, vol. 8, no. 1, pp. 24-6.
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Abstract Objectives Hypertension is the leading modifiable cause of mortality worldwide. Unlike many conditions where limited evidence exists for management of older individuals, multiple large, robust trials have provided a solid evidence-base regarding the management of hypertension in older adults. Understanding the impact of age on how the prevalence of hypertension and the role of pharmacotherapy in managing hypertension among older persons is a critical element is the provision of optimal health care for older populations. The aim of this study was to explore how the prevalence of hypertension changes with age, the evidence regarding pharmacological management in older adults and to identify known barriers to the optimal management of hypertension in older patients. Methods A review of English language studies published prior to 2013 in Medline, Embase and Google scholar was conducted. Key search terms included hypertension, pharmacotherapy, and aged. Results The prevalence of hypertension was shown to increase with age, however there is good evidence for the use of a number of pharmacological agents to control blood pressure in older populations. System, physician and patient related barriers to optimal blood pressure control were identified. Conclusions Despite good evidence for pharmacological management of hypertension among olderpopulations, under treatment of hypertension is an issue. Concerns regarding adverse effects appearcentral to under treatment of hypertension among older populations.
Basyouni, MH, BinDhim, NF, Saini, B & Williams, KA 2015, 'Online Health Information Needs for Patients with Asthma in Saudi Arabia', Journal of Consumer Health on the Internet, vol. 19, no. 1, pp. 13-24.
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© 2015, Published with license by Taylor & Francis. This study aims to identify the online asthma informational needs of patients with asthma in Saudi Arabia, explore participants’ previous use of and interest in online asthma health information, and explore factors associated with online information-seeking and needs. A self-administered questionnaire was developed based on similar studies of asthma patients’ education and completed by a convenient sample of 83 asthma patients attending the outpatient pulmonary clinic at the Security Forces Hospital Program in Riyadh. Approximately two-thirds of participants who use the Internet have searched for asthma information online. Thirteen percent of the participants reported that the Internet was their main source of information about asthma, and 33.7% reported that the Internet was their favorite additional source of information about asthma. Seventy-eight percent of the participants were interested in an asthma information Web site in the Arabic language. Employment and higher income were associated with participants who chose the Internet as the favorite source of additional information about asthma (OR 4.5, 95%CI 1.6–12.7) and (OR 4.2, 95%CI 1.4–12.5), respectively, and an education level higher than high school was associated with participants who previously had looked for online information about asthma (OR 11.2, 95%CI 3.8.6–33.5).
BinDhim, NF, Shaman, AM, Trevena, L, Basyouni, MH, Pont, LG & Alhawassi, TM 2015, 'Depression screening via a smartphone app: cross-country user characteristics and feasibility', Journal of the American Medical Informatics Association, vol. 22, no. 1, pp. 29-34.
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Abstract Background and objective Smartphone applications (apps) have the potential to be valuable self-help interventions for depression screening. However, information about their feasibility and effectiveness and the characteristics of app users is limited. The aim of this study is to explore the uptake, utilization, and characteristics of voluntary users of an app for depression screening. Methods This was a cross-sectional study of a free depression screening smartphone app that contains the demographics, patient health questionnaire (PHQ-9), brief anxiety test, personalized recommendation based on the participant's results, and links to depression-relevant websites. The free app was released globally via Apple's App Store. Participants aged 18 and older downloaded the study app and were recruited passively between September 2012 and January 2013. Findings 8241 participants from 66 countries had downloaded the app, with a response rate of 73.9%. While one quarter of the participants had a previous diagnosis of depression, the prevalence of participants with a higher risk of depression was 82.5% and 66.8% at PHQ-9 cut-off 11 and cut-off 15, respectively. Many of the participants had one or more physical comorbid conditions and suicidal ideation. The cut-off 11 (OR: 1.4; 95% CI 1.2 to 1.6), previous depression diagnosis (OR: 1.3; 95% CI1.2 to 1.5), and postgraduate educational level (OR: 1.2; 95% CI 1.0 to 1.5) were associated with completing the PHQ-9 questionnaire more than once. Conclusions Smartphone apps can be used to deliver a screening tool for depression across a large number of countries. Apps have the potential to play a significant role in disease screening, self-management, monitoring, and health education, particularly among younger adults.
Dua, K, Sheshala, R, Al-Waeli, H, Gupta, G & Chellappan, D 2015, 'Antimicrobial Efficacy of Extemporaneously Prepared Herbal Mouthwashes', Recent Patents on Drug Delivery & Formulation, vol. 9, no. 3, pp. 201-205.
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Natural products like plants and its components have been in use for treatment and cure of diseases all around the globe from ancient times much before the discovery of the current modern drugs. These substances from the nature are well known to contain components which have therapeutic properties and can also behave as precursors for the synthesis of potential drugs. The beneficial results from herbal drugs are well reported where their popularity in usage has increased across the globe. Subsequently developing countries are now recognizing the many positive advantages from their use which has engaged the expansion of R & D from herbal research. The flow on effect from this expansion has increased the awareness to develop new herbal products and the processes, throughout the entire world. Mouth washes and mouth rinses which have plant oils, plant components or extracts have generated particular attention. High prevalence of gingival inflammation and periodontal diseases, suggests majority of the patients practice inadequate plaque control. Of the currently available mouthwashes in the market, Chlorhexidine gluconate (CHX) has been investigated on a larger scale with much detail. CHX is associated with side effects like staining of teeth when used daily as well as the bitter taste of the mouthwash which leads to patient incompliance. The present research encompasses the antibacterial activity of extemporaneously prepared herbal mouthwash using natural herbs and therefore allows for the potential commercialization with in the herbal and pharmaceutical industries. Also, the present research article reviewed details of various existing patents of herbal mouthwashes which shows the trend of existing market and significance of emerging mouthwashes in both pharmaceutical and herbal industries. The antimicrobial activity of prepared mouthwashes was found to be effective against various strains of bacteria. It also suggests that the prepared herbal mouthwashes may provid...
Dua, K, Sheshala, R, Al-Waeli, HA, Gupta, G & Chellappan, DK 2015, 'Antimicrobial Efficacy of Extemporaneously Prepared Herbal Mouthwashes.', Recent Pat Drug Deliv Formul, vol. 9, no. 3, pp. 257-261.
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Natural products like plants and its components have been in use for treatment and cure of diseases all around the globe from ancient times much before the discovery of the current modern drugs. These substances from the nature are well known to contain components which have therapeutic properties and can also behave as precursors for the synthesis of potential drugs. The beneficial results from herbal drugs are well reported where their popularity in usage has increased across the globe. Subsequently developing countries are now recognizing the many positive advantages from their use which has engaged the expansion of R & D from herbal research. The flow on effect from this expansion has increased the awareness to develop new herbal products and the processes, throughout the entire world. Mouth washes and mouth rinses which have plant oils, plant components or extracts have generated particular attention. High prevalence of gingival inflammation and periodontal diseases, suggests majority of the patients practice inadequate plaque control. Of the currently available mouthwashes in the market, Chlorhexidine gluconate (CHX) has been investigated on a larger scale with much detail. CHX is associated with side effects like staining of teeth when used daily as well as the bitter taste of the mouthwash which leads to patient incompliance. The present research encompasses the antibacterial activity of extemporaneously prepared herbal mouthwash using natural herbs and therefore allows for the potential commercialization with in the herbal and pharmaceutical industries. Also, the present research article reviewed details of various existing patents of herbal mouthwashes which shows the trend of existing market and significance of emerging mouthwashes in both pharmaceutical and herbal industries. The antimicrobial activity of prepared mouthwashes was found to be effective against various strains of bacteria. It also suggests that the prepared herbal mouthwashes ...
Gadzhanova, S, Roughead, EE & Pont, LG 2015, 'Safety of opioid patch initiation in Australian residential aged care', The Medical journal of Australia, vol. 203, no. 7, pp. 298-298.
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OBJECTIVE: To explore opioid use by aged care facility residents before and after initiation of transdermal opioid patches. DESIGN: A cross-sectional cohort study, analysing pharmacy data on individual patient supply between 1 July 2008 and 30 September 2013. SETTING: Sixty residential aged care facilities in New South Wales. PARTICIPANTS: Residents receiving an initial opioid patch during the study period. MAIN OUTCOME MEASURE: The proportion of residents who were opioid-naive in the 4 weeks prior to patch initiation was determined. In addition, the patch strength at initiation and the daily dose of transdermal patches and of additional opioids 1 month after initiation were determined. RESULTS: An opioid patch was initiated in 596 of 5297 residents (11.3%: 2.6% fentanyl, 8.7% buprenorphine) in the 60 residential aged care facilities. The mean age at initiation was 87 years, and 74% of the recipients were women. The proportion of recipients who were opioid-naive before patch initiation was 34% for fentanyl and 49% for buprenorphine. Most were initiated at the lowest available patch strength, and the dose was up-titrated after initiation. Around 15% of fentanyl users and 10% of buprenorphine users needed additional regular opioids after patch initiation. CONCLUSIONS: The results suggest some inappropriate initiation of opioid patches in Australian residential aged care facilities. Contrary to best practice, a third of residents initiated on fentanyl patches were opioid-naive in the 4 weeks before initiation.
Gadzhanova, S, Roughead, EE & Pont, LG 2015, 'Safety of opioid patch initiation in Australian residential aged care', Medical Journal of Australia, vol. 203, no. 7, pp. 298-298.
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OBJECTIVE: To explore opioid use by aged care facility residents before and after initiation of transdermal opioid patches. DESIGN: A cross-sectional cohort study, analysing pharmacy data on individual patient supply between 1 July 2008 and 30 September 2013. SETTING: Sixty residential aged care facilities in New South Wales. PARTICIPANTS: Residents receiving an initial opioid patch during the study period. MAIN OUTCOME MEASURE: The proportion of residents who were opioid-naive in the 4 weeks prior to patch initiation was determined. In addition, the patch strength at initiation and the daily dose of transdermal patches and of additional opioids 1 month after initiation were determined. RESULTS: An opioid patch was initiated in 596 of 5297 residents (11.3%: 2.6% fentanyl, 8.7% buprenorphine) in the 60 residential aged care facilities. The mean age at initiation was 87 years, and 74% of the recipients were women. The proportion of recipients who were opioid-naive before patch initiation was 34% for fentanyl and 49% for buprenorphine. Most were initiated at the lowest available patch strength, and the dose was up-titrated after initiation. Around 15% of fentanyl users and 10% of buprenorphine users needed additional regular opioids after patch initiation. CONCLUSIONS: The results suggest some inappropriate initiation of opioid patches in Australian residential aged care facilities. Contrary to best practice, a third of residents initiated on fentanyl patches were opioid-naive in the 4 weeks before initiation.
Gorajana, A, Kit, W & Dua, K 2015, 'Characterization and Solubility Study of Norfloxacin-Polyethylene Glycol, Polyvinylpyrrolidone and Carbopol 974p Solid Dispersions', Recent Patents on Drug Delivery & Formulation, vol. 9, no. 2, pp. 167-182.
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Objective: Norfloxacin has a low aqueous solubility which leads to poor dissolution. Keeping this fact in mind the purpose of the present study is to formulate and evaluate norfloxacin solid dispersion. Methods: Solid dispersions were prepared using hydrophilic carriers like polyethylene glycol (PEG) 4000, polyvinylpyrrolidone (PVP) k30 and carbopol 974pNF (CP) in various ratios using solvent evaporation technique. These formulations were evaluated using solubility studies, dissolution studies; Fourier transmitted infrared spectroscopy (FTIR), X-ray diffraction (XRD), and differential scanning calorimetery (DSC). The influence of polymer type and drug to polymer ratio on the solubility and dissolution rate of norfloxacin was also evaluated. Results: FTIR analysis showed no interaction of all three polymers with norfloxacin. The results from XRD and DSC analyses of the solid dispersion preparations showed that norfloxacin existsin its amorphous form. Among the Norfloxacin: PEG solid dispersions, Norfloxacin: PEG 1:14 ratio showed the highest dissolution rate at pH 6.8. For norfloxacin: PVP solid dispersions, norfloxacin: PVP 1:10 ratio showed the highest dissolution rate at pH 6.8. For Norfloxacin: CP solid dispersions, norfloxacin: P 1:2 ratio showed the highest dissolution rate at pH 6.8. Conclusion: The solid dispersion of norfloxacin with polyethylene glycol (PEG) 4000, polyvinylpyrrolidone (PVP) k30 and carbopol 974p NF (CP), lends an ample credence for better therapeutic efficacy.
Gorajana, A, Rajendran, A, Yew, L & Dua, K 2015, 'Preparation and characterization of cefuroxime axetil solid dispersions using hydrophilic carriers', International Journal of Pharmaceutical Investigation, vol. 5, no. 3, pp. 171-171.
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Aim
The objective of the current study is to increase the dissolution rate of cefuroxime axetil (CA) by formation of binary CA solid dispersion using water soluble carriers such as polyvinylpyrrolidone (PVP K30) and polyethylene glycol (PEG 4000).
Methods
Solid dispersions (SDs) between CA and PVP K30/PEG 4000 were formed by dissolving both compounds in a common solvent, methanol, which were rotary evaporated at 40°C for 12 h. Physical mixtures between CA and PVP K30/PEG 4000 were also formulated as to compare the efficiency of SDs. The physicochemical properties of CA and all its formulations were then characterized using differential scanning calorimetric analysis (DSC), powder X-ray diffraction studies (PXRD), and Fourier transform infrared spectroscopy (FTIR).
Results
All SD formulations were found to have a higher dissolution rate comparatively to pure CA, while only physical mixtures of PVP K30 were found having a significantly higher dissolution rate. The enhancement of dissolution rate SD by PVP K30 may be caused by increase wettability, solubility, reduction in particle size or the formation of CA β crystalline. Increment of dissolution rate of CA SDs by PEG 4000 similarly may be caused by increase wettability, solubility, and reduction in particle size. This phenomenon may also be caused by amorphization as suggested by DSC and PXRD.
Conclusions
The SD of CA with PVP K30 and PEG 4000, lends an ample credence for better therapeutic efficacy.
Gupta, G, Jia Jia, T, Yee Woon, L, Kumar Chellappan, D, Candasamy, M & Dua, K 2015, 'Pharmacological Evaluation of Antidepressant-Like Effect of Genistein and Its Combination with Amitriptyline: An Acute and Chronic Study', Advances in Pharmacological Sciences, vol. 2015, pp. 1-6.
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The present study was designed to evaluate the acute and chronic antidepressant effect of genistein in combination with amitriptyline in mice. Animals were divided into six groups (n=6) for treatment with water, genistein, or amitriptyline, either alone or in combination for ten days. Animals were subjected to locomotor activity testing; tail suspension test (TST); and forced swim test (FST) and immobility time was recorded on day one and day ten. Acute treatment of all treatment groups did not significantly reduce the immobility time (p>0.05). Chronic treatment of combination of genistein (10 mg/kg) and amitriptyline (5 mg/kg and 10 mg/kg) significantly reduced the immobility time as compared to control group (p<0.001) and was comparable to amitriptyline alone (10 mg/kg). However, no changes in anti-immobility activity in combination of subeffective doses of genistein (5 mg/kg) and amitriptyline (5 mg/kg) were observed. Genistein at its standard dose (10 mg/kg) rendered synergistic effects in combination with subeffective dose of amitriptyline (5 mg/kg) and additive effects in combination with therapeutic dose of amitriptyline (10 mg/kg).
Madan, J, Adokar, B & Dua, K 2015, 'Development and evaluation of in situ gel of pregabalin', International Journal of Pharmaceutical Investigation, vol. 5, no. 4, pp. 226-226.
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Aim and background
Pregabalin (PRG), an analog of gamma-aminobutyric acid, reduces the release of many neurotransmitters, including glutamate, and noradrenaline. It is used for the treatment of epilepsy; simple and complex partial convulsion. The present research work aims to ensure a high drug absorption by retarding the advancement of PRG formulation through the gastrointestinal tract. The work aims to design a controlled release PRG formulation which is administered as liquid and further gels in the stomach and floats in gastric juice.
Materials and methods
In situ gelling formulations were prepared using sodium alginate, calcium chloride, sodium citrate, hydroxypropyl methylcellulose (HPMC) K100M, and sodium bicarbonate. The prepared formulations were evaluated for solution viscosity, drug content, in vitro gelling studies, gel strength, and in vitro drug release. The final formulation was optimized using a 3(2) full factorial design.
Results
The formulation containing 2.5% w/v sodium alginate and 0.2% w/v calcium chloride were considered optimum since it showed minimum floating lag time (18 s), optimum viscosity (287.3 cps), and gel strength (4087.17 dyne/cm(2)). The optimized formulation follows Korsmeyer-Peppas kinetic model with n value 0.3767 representing Fickian diffusion mechanism of drug release.
Conclusion
Floating in situ gelling system of PRG can be formulated using sodium alginate as a gelling polymer and calcium chloride as a complexing agent to control the drug release for about 12 h for the treatment of epilepsy.
Madan, J, Pawar, K & Dua, K 2015, 'Solubility enhancement studies on lurasidone hydrochloride using mixed hydrotropy', International Journal of Pharmaceutical Investigation, vol. 5, no. 2, pp. 114-114.
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Low aqueous solubility is a major problem faced during formulation development of new drug molecules. Lurasidone HCl (LRD) is an antipsychotic agent specially used in the treatments of schizophrenia and is a good example of the problems associated with low aqueous solubility. Lurasidone is practically insoluble in water, has poor bioavailability and slow onset of action and therefore cannot be given in emergency clinical situations like schizophrenia. Hence, purpose of this research was to provide a fast dissolving oral dosage form of Lurasidone. This dosage form can provide quick onset of action by using the concept of mixed hydrotropy. Initially, solubility of LRD was determined individually in nicotinamide, sodium citrate, urea and sodium benzoate at concentration of 10, 20, 30 and 40% w/v solutions using purified water as a solvent. Highest solubility was obtained in 40% sodium benzoate solution. In order to decrease the individual hydrotrope concentration mixed hydrotropic agents were used. Highest solubility was obtained in 15:20:5 ratio of Nicotinamide + sodium benzoate + sodium citrate. This optimized combination was utilized in the preparation of solid dispersions by using distilled water as a solvent. Solid dispersions were evaluated for X-ray diffraction, differential scanning calorimetry and Fourier-transform infrared to show no drug-hydrotropes interaction has occurred. This solid dispersion was compressed to form fast dissolving tablets. Dissolution studies of prepared tablets were done using USP Type II apparatus. The batch L3 tablets show 88% cumulative drug release within 14 min and in vitro dispersion time was 32 min. It was concluded that the concept of mixed hydrotropic solid dispersion is novel, safe and cost-effective technique for enhancing the bioavailability of poorly water-soluble drugs. The miraculous enhancement in solubility and bioavailability of Lurasidone is clear indication of the potential of mixed hydrotropy to be used in future...
Pont, LG 2015, 'Barriers and facilitators to the provision of clinical pharmacy services in Aboriginal communities', Journal of Pharmacy Practice and Research, vol. 45, no. 2, pp. 248-248.
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Pont, LG, Nielen, JTH, McLachlan, AJ, Gnjidic, D, Chan, L, Cumming, RG & Taxis, K 2015, 'Measuring anticholinergic drug exposure in older community‐dwelling Australian men: a comparison of four different measures', British Journal of Clinical Pharmacology, vol. 80, no. 5, pp. 1169-1175.
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AimsAnticholinergic drug exposure is associated with adverse outcomes in older people. While a number of tools have been developed to measure anticholinergic drug exposure, there is limited information about the agreement and overlap between the various scales. The aim of this study was to investigate the agreement and overlap between different measures of anticholinergic drug exposure in a cohort of community‐dwelling older men.MethodsA cross‐sectional study was used to compare anticholinergic drug exposure calculated using the Anticholinergic Risk Scale (ARS), the Anticholinergic Drug Scale (ADS), the Anticholinergic Cognitive Burden (ACB) and the Drug Burden Index anticholinergic subscale (DBI‐ACH) in a cohort of community‐dwelling men aged 70 years and older (n = 1696). Statistical agreement, expressed as Cohen's kappa (κ), between these measurements was calculated.ResultsDifferences were found between the tools regarding the classification of anticholinergic drug exposure for individual participants. Thirteen percent of the population used a drug listed as anticholinergic on the ARS, 39% used a drug listed on the ADS and the ACB, and 18% of the population used one or more anticholinergic drugs listed on the DBI‐ACH. While agreement was good between the ACB and ADS (κ = 0.628, 95% CI 0.593, 0.664), little agreement was found between remaining tools (κ = 0.091–0.264).ConclusionsWith the exception of the ACB and ADS, there was poor agreement regarding anticholinergic drug exposure among the four tools compared in this study. Great care should be taken when interpreting anticholinergic drug exposure using existing scales due to the wide variability between the different scales.
R. Madan, J, S. Argade, N & Dua, K 2015, 'Formulation and Evaluation of Transdermal Patches of Donepezil', Recent Patents on Drug Delivery & Formulation, vol. 9, no. 1, pp. 95-103.
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Aims and Background: Donepezil (DNZ) is a centrally acting reversible acetyl cholinesterase inhibitor. The main therapeutic use of donepezil is in the treatment of Alzheimer’s disease. The present research work pertains to the preparation of transdermal patches of donepezil with the objective to improve its patient compliance, therapeutic efficacy and to reduce the frequency of dosing and side effects as well as to avoid its extensive first pass metabolism. The recent patents on Rivastigmine (WO2013150542A2), Xanomeline (US5980933A) and Propentofylline (CA2255580A1) helped in selecting the drug and polymers. Materials and Methods: The transdermal patches were prepared using various polymers in combination with the plasticizer and penetration enhancers. The physicochemical parameters like folding endurance, thickness, drug content, content uniformity, moisture absorption, weight variation, and drug permeation studies of the optimized patches were studied. Results: The system containing Eudragit S-100, Eudragit E-100 and HPMC as matrix forming agent and glycerine as plasticizer was the best formulation. The in vitro release data was treated with kinetic equations and it followed zero order release. The diffusion study was carried out using rat skin showed 89% drug was released within 72 hours. Tween-80 (0.83% w/w) was found to be the best among all penetration enhancers. All the transdermal patches had the desired physical properties like tensile strength, folding endurance, flatness and water vapor transmission rate etc. Conclusion: The study concluded that that transdermal patch can extend the release of donepezil for many hours and also ensure enhanced bioavailability, further it also helps in avoiding the first pass effect.
Sheshala, R, Kok, Y, Ng, J, Thakur, R & Dua, K 2015, 'In Situ Gelling Ophthalmic Drug Delivery System: An Overview and Its Applications', Recent Patents on Drug Delivery & Formulation, vol. 9, no. 3, pp. 242-253.
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Ophthalmic drug delivery system is very interesting and challenging due to the normal physiologically factor of eyes which reduces the bioavailability of ocular products. The development of new ophthalmic dosage forms for existing drugs to improve efficacy and bioavailability, patient compliance and convenience has become one of the main trend in the pharmaceuticals industry. The present review encompasses various conventional and novel ocular drug delivery systems, methods of preparation, characterization and recent research in this area. Furthermore, the information on various commercially available in situ gel preparations and the existing patents of in situ drug delivery systems i.e. in situ gel formation of pectin, in situ gel for therapeutic use, medical uses of in situ formed gels and in situ gelling systems as sustained delivery for front of eye are also covered in this review.
Sheshala, R, Kok, YY, Ng, JM, Thakur, RRS & Dua, K 2015, 'In Situ Gelling Ophthalmic Drug Delivery System: An Overview and Its Applications.', Recent Pat Drug Deliv Formul, vol. 9, no. 3, pp. 237-248.
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Ophthalmic drug delivery system is very interesting and challenging due to the normal physiologically factor of eyes which reduces the bioavailability of ocular products. The development of new ophthalmic dosage forms for existing drugs to improve efficacy and bioavailability, patient compliance and convenience has become one of the main trend in the pharmaceuticals industry. The present review encompasses various conventional and novel ocular drug delivery systems, methods of preparation, characterization and recent research in this area. Furthermore, the information on various commercially available in situ gel preparations and the existing patents of in situ drug delivery systems i.e. in situ gel formation of pectin, in situ gel for therapeutic use, medical uses of in situ formed gels and in situ gelling systems as sustained delivery for front of eye are also covered in this review.
Werth, BL, Williams, KA & Pont, LG 2015, 'A longitudinal study of constipation and laxative use in a community-dwelling elderly population', Archives of Gerontology and Geriatrics, vol. 60, no. 3, pp. 418-424.
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Background: Little is known about laxative use, the association of constipation with laxative use, risk factors for constipation and how each of these changes over time in the community-dwelling elderly. Objective: The aim was to explore the prevalence of laxative use and of self-reported constipation, and identify risk factors (including age) associated with constipation, in a cohort of community-dwelling elderly residents. Methods: Data from the Australian Longitudinal Study of Ageing (ALSA) was used to compare differences in constipation and laxative use in the community-dwelling elderly between 1992-1993 and 2003-2004. Results: Relevant data was available for 239 ALSA participants. The prevalence of self-reported constipation increased from 14% in 1992-1993 to 21% in 2003-2004. There was a corresponding increase in the prevalence of laxative use from 6% to 15% over the same period. At both time points, females reported a higher prevalence of both constipation and laxative use however the female:male prevalence ratios decreased over time indicating higher increases in the prevalence of each among males. Persistent chronic constipation occurred in 9% of the cohort. The association between laxative use and self-reported constipation was poor and laxative use was associated with self-reported constipation in less than a third of cases. Conclusion: The prevalence of both constipation and laxative use increases with age in the elderly, and these increases are greater for males than for females. Discrepancies between self-reported constipation and laxative use may suggest sub-optimal management of constipation in the community-dwelling elderly and further work is needed to fully understand this.
Zhu, B, Haghi, M, Nguyen, A, Goud, M, Yeung, S, Young, PM & Traini, D 2015, 'Delivery of theophylline as dry powder for inhalation', Asian Journal of Pharmaceutical Sciences, vol. 10, no. 6, pp. 520-527.
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© 2015 The Authors. Theophylline (TP) is a very well established orally or intravenously delivered antiasthma drug with many beneficial effects. This study aims to improve asthma treatment by creating a dry powder inhalable (DPI) formulation of TP to be delivered directly to the lung, avoiding the side effects associated with conventional oral delivery. The DPI TP formulation was investigated for its physico-chemical characteristics using scanning electron microscopy, laser diffraction, thermal analysis and dynamic vapour sorption. Furthermore, aerosol performance was assessed using the Multi Stage Liquid Impinger (MSLI). In addition, a Calu-3 cell transport assay was conducted in vitro using a modified ACI to study the impact of the DPI formulation on lung epithelial cells. Results showed DPI TP to be physico-chemically stable and of an aerodynamic size suitable for lung delivery. The aerosolisation performance analysis showed the TP DPI formulation to have a fine particle fraction of 29.70 ± 2.59% (P < 0.05) for the TP formulation containing 1.0% (w/w) sodium stearate, the most efficient for aerosolisation. Regarding the deposition of TP DPI on Calu-3 cells using the modified ACI, results demonstrated that 56.14 ± 7.62% of the total TP deposited (13.07 ± 1.69 μg) was transported across the Calu-3 monolayer over 180 min following deposition, while 37.05 ± 12.62% of the deposited TP was retained in the cells. This could be due to the presence of sodium stearate in the current formulation that increased its lipophilicity. A DPI formulation of TP was developed that was shown to be suitable for inhalation.
Alhawassi, TM, Krass, I & Pont, LG 1970, 'Effect of Hospital Admission on Antihypertensive Medication Utilization Among Older Persons', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, WILEY-BLACKWELL, pp. 80-81.
Alhawassi, TM, Krass, I & Pont, LG 1970, 'Hypertension management and control in older persons on admission to an acute care setting', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, WILEY-BLACKWELL, pp. 93-94.
Alhawassi, TM, Krass, I & Pont, LG 1970, 'Prevalence and risk factors for adverse drug reactions in older adults in the acute care setting', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, WILEY-BLACKWELL, pp. 91-91.
Bosnic-Anticevich, S, Lim, D, Steel, J, Kritikos, V, Nikolaou, V, Bjermer, L, Chrystyn, H, Lavorini, F, Dekhuijzen, R, Rand, C, Roche, N, Smith, L, Pont, L, Smita, S, Nicholas, Z & Price, D 1970, 'Investigating the maintenance of inhaler device mastery of healthcare professionals', ALLERGY, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, WILEY-BLACKWELL, Barcelona, SPAIN, pp. 645-645.
Caughey, G, Taxis, K, Wettermark, B, Sketris, I, Chen, L-C & Pont, L 1970, 'An International Working Collaborative to Examine Global Drug Utilisation: Opioid Use and Misuse', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, WILEY-BLACKWELL, pp. 43-44.
Pont, LG, van der Meer, H, Stevens, G, McLachlan, A & Taxis, K 1970, 'Changes in Drug Utilization at the End of Life', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, WILEY-BLACKWELL, pp. 35-36.
Pont, LG, Veal, C, Flemming, A, Low, L-F & Pinto, S 1970, 'Using Data to Change Drug Utilization in the Real World', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, WILEY-BLACKWELL, pp. 35-35.
